Chronic obstructive pulmonary disease (COPD) is a complex and progressive chronic lung disease.
Typically, COPD includes emphysema and chronic bronchitis.
COPD is characterized by the restriction of airflow into and out of the lungs. The obstruction of airflow makes breathing difficult.
The causes of COPD include smoking, long-term exposure to air pollutants, and a rare genetic disorder.
To understand the severity of COPD and how it affects people’s lives, doctors developed stages of COPD.
Here is the information you need to know about mild through end-stage COPD.
How are the Stages of COPD Determined?
The two most common ways to determine the stages of COPD include the GOLD Staging System and the BODE Index.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) developed the GOLD Staging System. In the GOLD System, the forced expiratory volume in one second (FEV1) measurement from a pulmonary function test is used to place COPD into stages.
Often, doctors also consider your COPD symptoms.
The BODE Index stands for body mass, obstruction of airflow, dyspnea (difficulty breathing) and exercise capacity. Doctors use the BODE Index to better understand how COPD affects your life and the severity of your symptoms.
Other types of lung function tests may also be needed to help doctors figure out your stage of COPD.
These tests include gas diffusion tests, 6-minute walk tests, body plethysmography, and spirometry.
What Are The Stages of COPD?
COPD has four stages. The stages of COPD range from mild to very severe. COPD affects everyone differently.
Because COPD is a progressive lung disease, it will worsen over time.
Your doctor will categorize your COPD stage based on your COPD symptoms and results from your lung function tests.
For some people, the stages of COPD develop slowly, but for some, the disease progresses rapidly.
Seeing your doctor regularly is important, even if you’re feeling well. Your doctor will track your condition over time.
This means that your doctor may recommend you have multiple pulmonary function tests, chest x-rays, CT scans, and other types of testing.
Your doctor can keep track of how well your lungs and COPD treatment plan are working, so he or she can modify your treatment plan as your stage of COPD changes.
As the stages of COPD increase, airflow becomes more limited.
The Stages of COPD:
- Mild COPD or Stage 1: Mild COPD with an FEV1 of about 80 percent or more than normal.
- Moderate COPD or Stage 2: Moderate COPD with an FEV1 between 50 and 80 percent of normal.
- Severe COPD or Stage 3: Severe emphysema with an FEV1 between 30 and 50 percent of normal.
- Very Severe COPD or Stage 4: Very severe or End-Stage COPD with a lower FEV1 than Stage 3, or people with low blood oxygen levels and a Stage 3 FEV1.
What Happens in Mild Stage COPD?
The first category is stage 1 or mild stage COPD. In stage 1 COPD, people may not realize that they have a problem yet.
Many people continue with their daily activities with slight limitations to their breathing. Some people experience a cough and phlegm.
It’s important to see a doctor and receive a diagnosis as early as possible. This way you and your doctor can work together to develop an individualized COPD treatment plan.
What Happens in Moderate Stage COPD?
Many people notice more coughing and mucus production during the moderate stage of COPD or stage 2.
People tend to seek medical care for limitations in breathing and increased symptoms.
At this stage, your doctor may prescribe bronchodilators to help you breathe better. Your doctor may also recommend pulmonary rehabilitation.
Participating in a pulmonary rehab program helps people with lung diseases learn how to breathe and function better.
It combines exercise, education and support, and you work with a team of doctors, nurses and medical specialists.
What Happens in Severe Stage COPD?
Stage 3 or severe stage COPD greatly impacts people’s quality of life. Lung function continues to decline, and breathing becomes more difficult.
COPD symptoms make it challenging to enjoy your favorite activities or perform daily tasks. During this stage, many people feel more fatigue and have difficulty exercising.
Your doctor may prescribe corticosteroids to help reduce inflammation, combination inhalers, and other medications or therapies.
What Happens in Very Severe or End-Stage COPD?
End-stage COPD or stage 4 is classified as very severe and often affects the quality of life profoundly. Flare-ups and breathing issues may become life-threatening.
Your doctor may add to your existing COPD treatment plan or change it based on your needs.
By end-stage COPD, many people have trouble receiving enough oxygen.
Low blood oxygen levels can lead to serious health conditions such as hypoxia or hypoxemia, cyanosis, and other problems.
When low blood oxygen levels occur, your doctor may prescribe oxygen therapy to help ensure your body receives adequate oxygen.
Taking Care of You and Your Lungs
Understanding the stages of COPD is one of the first steps you can take in becoming more proactive in your healthcare.
As your COPD progresses, continue working with your doctor to modify your treatment plan as needed.
Take note of any changes you notice in your symptoms, what triggers your symptoms to worsen and how COPD affects your ability to do daily activities.
See your doctor immediately if you feel unwell or have changes in your health.
Christine Kingsley, APRN is the Health and Wellness Director at the Lung Institute where she focuses on providing helpful online resources for people looking for information on various lung diseases, breathing exercises, and healthy lifestyle choices. She advocates for holistic care that involves working with your doctor to explore all options including traditional and alternative care while focusing on diet and exercise as proactive measures.